Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 063937 | GA |
N | 111NI0900X | Internist | 063937 | GA |
Y | 207RH0002X | Hospice and Palliative Medicine | 063937 | GA |
NPI | 1306053731 |
---|---|
Provider Name | Urviben Rekshitkumar Patel |
First Address | Macon, GA 31201-2102 |
Second Address | Cumming, GA 30041-7659 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2007 |
Last Update Date | 19/06/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
579369022H | (05) | GA |